Major reform planned for end of life care in London

March 4, 2010

A guide to transform Londoners’ experience of care at the end of their lives is launched today by Commissioning Support for London (CSL). The Healthcare for London End of life care good practice guide advises health care professionals on how to improve the experience of patients who die in the capital.

London lags behind the rest of the UK in end of life care. Research shows that most people when asked say they would prefer to die in their own homes but in London only 20% of people get their wish.

Over half of all complaints about hospitals investigated by the Healthcare Commission are about end of life care. Reports in 2007 found that, while in some areas 90% of GP surgeries conform to accepted good practice for end of life care, in London fewer than a quarter of surgeries use these techniques.

This new model would mean at least half of all deaths could take place outside of hospital care by March 2013. The guide also outlines ways to improve the experience of all patients who die in the care of health and social care services.

Teresa Tate*, Joint Clinical lead for the project, said: “Most people, when asked, say they would prefer to die in the comfort of their own home – but just 20% of Londoners who die each year actually get their wish. This guidance is about improving that.”

Rob George*, Joint Clinical lead for the project, adds: “People deserve to die in the place they choose and this project exists to improve and support the care required to make this a reality.”

Sarah Crowther, Executive Chair of CSL, further explains: “We have been working on reforming end of life care to improve services in London. The project has looked at ways to help patients choose where they spend their last days. The outcome is the development of the good practice guide to support London’s healthcare providers and commissioners improve end of life care in the capital.

“It advises on improving the ability of experts working in hospitals to recognise when a patient’s life is coming to an end, improve coordination between healthcare agencies and ensure they all work together in line with the new best practice.”

The guide has been produced by the Healthcare for London programme, in partnership with an expert clinical group and London-based commissioners. Stakeholders, including clinicians, patients, carers, third sector organisations and agencies, were also involved in the development of the guide.

The interactive online nature of the guide means it will be continually updated to reflect developments in practice and the impact of the quality markers on the delivery of services.

*Teresa Tate works at Barts and The London NHS Trust and is the Medical Director for Marie Curie Cancer Care.
**Rob George works at Guys and St Thomas’ Hospital